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This article examines how critical thinking is seen in learning decision making during the clinical lessons in the beginning of nursing students' clinical education. The data has been collected by taping all the clinical lessons (11) of the students (32). The data was analyzed by using content analysis both quantitatively and qualitatively. The phases of the nursing process, in other words the phases of decision making appeared clearly in the discussions. A lot of assessment of the nursing needs of the patient appeared clearly. Physical needs were focused among the nursing problems. The objects of the nursing were defined nurse-centrically and generally. The discussion about the implementation and the evaluation of the nursing received insufficient attention. There were presented neither alternative solutions of the care nor any reasons for proposed solutions. Learning of the students represented mainly superficial, mechanical learning, lacking critical thinking.

In the middle of 1980s in Finland the evaluation of the quality of learning was developed according the principles of the responsive student evaluation. These principles consist of goal orientation and critical attitude of one's own and others' action. In this article the realization of the principles is described, from the perspective of nursing students (N = 379) and based on a questionnaire. The students answered to the questionnaire before their graduation in the autumn-term 1990. The main part of the students was during their education aware of the goals in curriculum and stated the goals also themselves. Between the goal-orientation and grades in certification there was, however, no correlation. In clinical practice the students evaluated the action of their own and supervisors. In the evaluation of more theoretical learning (e.g. in class-room) the role of the students was very limited. Based on the questionnaire it is presumable that the principles of responsive student-evaluation realize only partly in the Finnish professional nursing education.

The study examines the implementation of nursing care and uses information derived from the nursing plan as its point of departure. The focus is on the acute nursing phase of stroke patients in the Stroke Unit. The study is based on the theoretical model presented by Roper et al. (1985). The study depicts the components of the nursing care of stroke patients. It was found that the sixty-two (62) stroke patients received a total of 17,125 nursing interventions of different kinds. In the acute phase, the focus seems to be on maintaining the vital functions. The results help nurses to improve the nursing care given to these patients.

The aim of the study was to find out nursing students opinions and knowledge of suicide phenomenon. Altogether 132 students from Turku and Salo nursing schools participated and they were specialized in surgical & internal, psychiatric and public health. Their basic education also varied, but the purpose was to find students who were near to graduate. The data was collected with an inquire (eleven non-structured questions) and was analyzed with content analysis. Students had relatively short working life experience and according to their own experience too little knowledge and capability to face suicide phenomenon. Majority of the respondents thought that a person who commits suicide is weak, doesn't talk and is a heavy drinker and the reasons to commit suicide are personal. These reasons are among other things weak self-confidence, speechless and personal problems. Suicide prevention has place in every level of the society and specially in health care, among mental health care personnel and in social work.

The purpose of this study was to describe the contents and patterns of interaction between clients (mother and child under one year of age) and public health nurses in child health care at Finnish health centers. The data were collected by observing client--public health nurse interactions during the visits. The data reported in this article were collected during 1987-1989. Totally 1554 interactions were observed out of 20 visits to child health centers. The data were analyzed according to grounded theory method. The contents of the interaction between clients and public health nurses concentrated on child's growth and development. Additionally, family issues like relationships in the family and relatives were discussed. Situational matters during the visit were also included in the contents. Various relationships were identified between child and mother, child and public health nurse and mother and public health nurse. The relationship between child and mother during the visit was called a tenderness, protective and persuasive relationship. The relationship between child and public health nurse was called a persuasive and entertainment relationship. The main relationship between mother and public health nurse was called relationship supporting selfconfidence. This study has produced descriptive knowledge about interactions in health care.

This paper reviews the current status of habits regarding physical restraint use with the demented patients. The data was collected by observing the basic care of the demented patient in various types of institutions and by interviewing the nurses working on these wards (N = 52). The most common reasons for the use of restraints with the demented patient were protection of patient, management of basic nursing actions, the demented patient's characteristics and because of routine. Alternatives to restraints were reasoning, changes in the environment, increasing interaction between nurse and patient, bearing, taking into consideration patient's will in giving basic nursing care and all injuries can not be prevented.

Delphi method in nursing research is unusual but worthy of attention. The foundation of the method is experience-based knowledge and interaction of experts in successive rounds. Usually delphi method does not produce objective, exact facts. Delphi method is applicable to identifying and clarifying new issues and assumptions and producing well-grounded evaluations--often important in young disciplines. However, critical attitude is needed regarding methodological decisions as well as implications.

This study is a part of the research project "Multidimensional Health" and consists of a theoretical and on empirical part. The theoretical part analyzes the concepts of health and processes of health, taking as its theoretical frame of reference the theories of Eriksson. The empirical part is a study of the processes of health of fourteen patients in psychiatric health care and is a hermeneutical study. The aim is to describe and to understand multidimensional health, integrating processes of health and the factors guiding or directing them. The premise that health is relative is verified by the results. The dominating pattern of the processes of health suggests that they are integrating. Man's consciousness of his own potential wholeness, the experience of being accepted in relation to the concrete and the abstract other, and the experience of his own place are essential parts of integrating processes of health.

The patient-nurse relationship, its definition and evaluation, are central to the quality of nursing care. Analysis of this relationship requires a stronger epistemological and philosophical emphasis and also more practical research. At least the following dimensions must be included in: 1) the health management strategies of the patients and population; these form the content of the client-nurse relationship; and 2) the dominance factors of the relationships, which form the structure of the relationship.

This article reviews the ethical decision making in moving to terminal care in different nursing unites from viewpoint of nurses. The research results presented in this article are part of the larger study, which dealt with the terminal care of an elderly patient (Kuuppelomaki 1991). Nurses, special nurses and head nurses (N = 191) working in local hospitals, in central hospitals and in radiotherapy clinics participated in the study. The research material was collected by questionnaires during august and september in year 1989. In the processing of the research material cross-tabulations were used. The statistical significance of the differences in results of groups was tested by the Chi-Square. It was found out that the decision of terminal care is often left unmade both in local hospitals, in central hospitals and in radiotherapy clinics. According to the nurses patients and relatives didn't take part very much in decision making process. The participation of nurses were also more less than the willingness of them. Most often the decision was made by the doctor alone, especially in central hospital. Almost every patient in radiotherapy clinics knew about the decision of terminal care but in local hospitals and in central hospitals less than half of them knew about the thing.